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Year : 2021  |  Volume : 69  |  Issue : 7  |  Page : 98--104

Emerging Targets for Migraine Treatment


1 Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
2 NIHR-Wellcome Trust King's Clinical Research Facility/SLaM Biomedical Research Centre, King's College Hospital, London, United Kingdom; Department of Neurology, University of California, Los Angeles, Los Angeles CA USA

Correspondence Address:
Dr. Peter James Goadsby
Wellcome Foundation Building, King's College Hospital, London SE5 9PJ

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.315989

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Background: While understanding the pathophysiology of migraine has led to CGRP-based treatments, other potential targets have also been implicated in migraine. Objectives: To catalog new promising targets for the treatment of migraine. Methods: We completed a literature review focusing on 5HT1F, PACAP, melatonin, and orexins. Results: The 5HT1F receptor agonist lasmiditan, following two positive randomized placebo-controlled trials, was FDA-approved for the acute treatment of migraine. PACAP-38 has shown analogous evidence to what was obtained for CGRP with its localization in key structures, provocation tests, and positive studies when antagonizing its receptor in animal models, although a PAC-1 receptor monoclonal antibody study was negative. Melatonin has undergone several randomized controlled trials showing a positive trend. Filorexant is the only dual orexin receptor antagonist, which was tested in humans with negative results. Conclusions: Further and ongoing studies will determine the utility of these new therapies with lasmiditan and melatonin having demonstrated efficacy for the treatment of migraine.






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